Objectives: To assess the efficacy, side effects, and acceptability of medical abortion using oral mifepristone (200 mg) followed 24 h later by oral or sublingual misoprostol (400 μg).
Materials And Methods: A total of 93 women with pregnancies up to 56 days of gestational age were assigned to two groups according to the different misoprostol regimen (group I 400 μg orally and group II 400 μg sublingually). The principle outcome measure was complete abortion defined as a complete expulsion of intrauterine contents without a need for surgical intervention 7 days after the procedure.
Results: Successful abortion occurred in 87.5% of patients in group 1 and 95.5% patients in group 2 (p = 0.166, 95% CI -0.194, 0.033). The patient acceptability and satisfaction rates were similar in both the groups.
Conclusion: It is concluded that 400 μg of sublingual misoprostol is as effective as oral misoprostol 24 h after mifepristone for medical abortion of ≤ 56 days.
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Society of Family Planning Clinical Recommendation: Medication management for early pregnancy loss.
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Planned Parenthood South Atlantic, Raleigh, NC, USA and McLeod Regional Medical Center, Florence, SC, USA; University of Washington Department of Obstetrics and Gynecology, 1959 NE Pacific St, Box 356460, Seattle, WA 98005, USA; Pegasus Health Justice Center, Dallas, TX, 75207, USA; Washington University, St. Louis, MO, USA.
Early pregnancy loss (EPL), also known as miscarriage or spontaneous abortion, makes up 15-20% of all clinically recognized pregnancies. EPL is a broad term that includes intrauterine pregnancies (IUPs) with findings that suggest the pregnancy may not progress or definitely will not progress; pregnancies with a gestational sac (GS) in the lower endometrial cavity or endocervical canal in the process of expulsion; residual pregnancy tissue or persistent GS; and complete passage of the GS without residual tissue. This document addresses medication management of EPL in which the complete passage of the GS has not yet occurred, including pregnancies concerning for and diagnostic of EPL (sometimes called "missed abortion") and EPL in progress.
View Article and Find Full Text PDFEffectiveness and acceptability of a 24-h interval versus a 48-h interval between mifepristone intake and misoprostol administration for in-hospital abortion at 9-20 gestational weeks: an international, open-label, randomised, controlled, non-inferiority trial.
Lancet Glob Health
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Department of Women's and Children's Health, Karolinska Institutet, Stockholm, Sweden; WHO Collaborating Centre, Karolinska University Hospital, Stockholm, Sweden.
Background: Optimising management of second-trimester medical abortion is important, as complications increase with gestational age. We aimed to compare a 24-h interval with a 48-h interval between mifepristone intake and misoprostol administration in in-hospital, second-trimester medical abortion for effectiveness and acceptability.
Methods: This open-label, randomised, controlled, non-inferiority trial was conducted at nine hospitals in India, Sweden, Thailand, and Viet Nam among adults undergoing medical abortion for a singleton viable pregnancy at a gestation of between 9 weeks and 20 weeks.
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Ob/gyn Department, Faculty of Medicine, Cairo University, Cairo University, Cairo, Egypt.
Background: The prostaglandin E1 analog "misoprostol" is a drug that has powerful ecbolic effects and can be beneficial in the prevention and treatment of postpartum hemorrhage, which is the leading cause of maternal mortality worldwide.
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Article Synopsis
- A combination of mifepristone and misoprostol is recommended for inducing labor, with specific dosing guidelines based on gestation week (Grade B).
- For women with a history of previous cesarean sections, the safety of labor induction is uncertain, especially for those with multiple or atypical scars (Grade D).
- Parents should receive comprehensive discussions about their birth options (vaginal vs. cesarean), with a focus on the physical and psychological impacts, while also ensuring a supportive environment for grief (Grade C).
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Cochrane Database Syst Rev
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